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Clinical implication of LAVI over A’ ratio in patients with acute coronary syndrome.

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Clinical implication of LAVI over A’ ratio in patients with acute coronary syndrome.

Heart Asia. 2018;10(2):e011038

Authors: Matsuura H, Yamada A, Sugimoto K, Sugimoto K, Iwase M, Ishikawa T, Ishii J, Ozaki Y

Abstract
Purpose: The ratio of the left atrial volume index (LAVI) and late diastolic mitral annular velocity (A’) is a useful echocardiographic index for identifying advanced left ventricular (LV) diastolic dysfunction in patients with dyspnoea. We investigated the clinical implications and prognostic value of the aforementioned ratio (LAVI/A’) in patients with ST elevation (STE) or non-STE (NSTE) acute coronary syndrome (ACS).
Methods: We studied 212 patients with ACS. All patients underwent electrocardiography, echocardiography and measurement of plasma B-type natriuretic peptide (BNP) level on admission. The study endpoints were hospitalisation and mortality because of heart failure (HF).
Results: There was a significant, moderate positive correlation between LAVI/A’ and natural logarithm (Ln) BNP level among the participants (r=0.48, p<0.0001). During a mean follow-up of 17 months, eight patients died and nine patients were hospitalised because of HF. The receiver operating characteristics curve indicated that LAVI/A’≥3.0 predicted these events (log-rank, p=0.0021). A significant and moderate positive correlation existed between LAVI/A’ and Ln BNP level in the NSTE-ACS group (n=128; r=0.58, p<0.0001). However, the correlation between LAVI/A’ and Ln BNP level was weaker in the STE-ACS group (n=84; r=0.33, p=0.0017).
Conclusion: LAVI/A’ was related to plasma BNP levels in patients with ACS, particularly in those with NSTE-ACS. This index was useful for predicting cardiac events in patients with ACS.

PMID: 30018662 [PubMed]

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